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Images in neonatal medicine
Infected pericardial cyst: a rare cause of neonatal cardiac tamponade, successfully treated by percutaneous aspiration
  1. Balaganesh Karmegaraj1,
  2. Navaneetha Sasikumar2,
  3. Mahesh Kappanayil2,
  4. Madhavan Manikavasagam3,
  5. Raman Krishna Kumar2
  1. 1 Department of Pediatric Cardiology, Sowmi Fetal and Pediatric heart centre, Tirunelveli, Tamilnadu, India and Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
  2. 2 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
  3. 3 Department of Pediatrics, Lakshmi Madhavan Hospital, Tirunelveli, India
  1. Correspondence to Dr Balaganesh Karmegaraj, Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India; pedsheartkbg{at}gmail.com

http://dx.doi.org/10.1136/archdischild-2023-325690

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    A 15-day-old term male neonate presented with respiratory distress, tachycardia, cyanosis (SpO2 85%), periorbital puffiness and pedal oedema (figure 1A). Echocardiography showed suprasystemic pulmonary artery pressures and a large (2.7×3 cm) mass compressing the right heart, producing cardiac tamponade (figure 1B; online supplemental video 1). Saline contrast echocardiography (figure 1C; online supplemental video 2) does not show any communication with the circulation. Contrast cardiac CT angiogram showed a large lobulated pericardial cyst encircling and compressing the right heart without any communication with the circulation (figure 1D). 3D CT reconstruction showed mass effect on the right heart structures (figure 1E). Echocardiography-guided fine needle aspiration of the cyst was performed with surgical backup. A 30 mL of pus was aspirated, and …

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    Footnotes

    • Contributors BK diagnosed the disease by echocardiography, took relevant clinical pictures, wrote the manuscript and managed the case. MM reviewed the manuscript for relevant contents. NS confirmed the disease by cardiac CT, managed the case and reviewed the manuscript for relevant contents. MK confirmed the disease by cardiac CT, managed the case and reviewed the manuscript for relevant contents. RKK confirmed the disease by cardiac CT, managed the case and reviewed the manuscript for relevant contents.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.